Alloantibody Levels and Acute Humoral Rejection Early After Positive Crossmatch Kidney Transplantation

We examined the course of donor‐specific alloantibody (DSA) levels early after transplant and their relationship with acute humoral rejection (AHR) in two groups of positive crossmatch (+XM) kidney transplant recipients: High DSA group—41 recipients with a baseline T‐ or B‐cell flow crossmatch (TFXM...

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Bibliographic Details
Published in:American journal of transplantation 2008-12, Vol.8 (12), p.2684-2694
Main Authors: Burns, J. M., Cornell, L. D., Perry, D. K., Pollinger, H. S., Gloor, J. M., Kremers, W. K., Gandhi, M. J., Dean, P. G., Stegall, M. D.
Format: Article
Language:English
Subjects:
Acute humoral rejection
Adolescent
Adult
Aged
alloantibody
Antibody Formation - immunology
B-Lymphocytes - immunology
B-Lymphocytes - pathology
Biological and medical sciences
Creatinine - blood
Female
Graft Rejection - blood
Graft Rejection - immunology
Histocompatibility Testing
human leukocyte antigen
Humans
Isoantibodies - blood
kidney transplant
Kidney Transplantation - immunology
Kidney Transplantation - pathology
Male
Medical sciences
Middle Aged
positive crossmatch
Retrospective Studies
single antigen beads
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
T-Lymphocytes - immunology
T-Lymphocytes - pathology
Time Factors
Tissue Donors
Young Adult
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Summary:We examined the course of donor‐specific alloantibody (DSA) levels early after transplant and their relationship with acute humoral rejection (AHR) in two groups of positive crossmatch (+XM) kidney transplant recipients: High DSA group—41 recipients with a baseline T‐ or B‐cell flow crossmatch (TFXM, BFXM) channel shift ≥300 (molecules of equivalent soluble fluorochrome units (MESF) of approximately 19 300) who underwent pretransplant plasmapheresis (PP), and Low DSA group—29 recipients with a baseline channel shift 359 (MESF of approximately 34 000) developing AHR. The BFXM and the total DSA measured by single antigen beads correlated well across a wide spectrum suggesting that either could be used for monitoring. We conclude that AHR is associated with the development of High DSA levels posttransplant and protocols aimed at maintaining DSA at lower levels may decrease the incidence of AHR. Donor specific antibody (DSA) levels after positive crossmatch kidney transplant determine the incidence of acute humoral rejection (AHR), with the level of DSA necessary to cause AHR surprisingly consistent from patient to patient.
ISSN:1600-6135
1600-6143
DOI:10.1111/j.1600-6143.2008.02441.x